Abujamea Abdullah H, Albadr Fahad B, Asiri Arwa M
Department of Radiology and Medical Imaging, College of Medicine, King Saud University, Riyadh, KSA.
Department of Radiology and Medical Imaging, King Saud University Medical City, King Saud University, Riyadh, KSA.
Curr Med Imaging. 2025;21:e15734056343086. doi: 10.2174/0115734056343086250103020830.
Multiple sclerosis (MS) is one of the most common disabling central nervous system diseases affecting young adults. Magnetic resonance imaging (MRI) is an essential tool for diagnosing and following up multiple sclerosis. Over the years, many MRI techniques have been developed to improve the sensitivity of MS disease detection. In recent years synthetic MRI (sMRI) and quantitative MRI (qMRI) have gained traction in neuroimaging applications, providing more detailed information than traditional acquisition methods. These techniques enable the detection of microstructural changes in the brain with high sensitivity and robustness to inter-scanner and inter-observer variability. This study aims to evaluate the feasibility of using these techniques to avoid administering intravenous gadolinium-based contrast agents (GBCAs) for assessing MS disease activity and monitoring.
Forty-two known MS patients, aged 20 to 45, were scanned as part of their routine follow-up. MAGnetic resonance image Compilation (MAGiC) sequence, an implementation of synthetic MRI, was added to our institute's routine MS protocol to automatically generate quantitative maps of T1, T2, and PD. T1, T2, PD, and apparent diffusion coefficient (ADC) data were collected from regions of interest (ROIs) representing normalappearing white matter (NAWM), enhancing, and non-enhancing MS lesions. The extracted information was compared, and statistically analyzed, and the sensitivity and specificity were calculated.
The mean R1 (the reciprocal of T1) value of the non-enhancing MS lesions was 0.694 s-1 (T1=1440 ms), for enhancing lesions 1.015 s-1 (T1=985ms), and for NAWM 1.514 s-1 (T1=660ms). For R2 (the reciprocal of T2) values, the mean value was 6.816 s-1 (T2=146ms) for nonenhancing lesions, 8.944 s-1 (T2=112 ms) for enhancing lesions, and 1.916 s-1 (T2=522 ms) for NAWM. PD values averaged 93.069% for nonenhancing lesions, 82.260% for enhancing lesions, and 67.191% for NAWM. For ADC, the mean value for non-enhancing lesions was 1216.60×10-6 mm2/s, for enhancing lesions 1016.66×10-6 mm2/s, and for NAWM 770.51×10-6 mm2/s.
Our results indicate that enhancing and non-enhancing MS lesions significantly decrease R1 and R2 values. Non-enhancing lesions have significantly lower R1 and R2 values compared to enhancing lesions.
Conversely, PD values are significantly higher in non-enhancing lesions than in enhancing lesions. For ADC, while NAWM has lower values, there was minimal difference between the mean ADC values of enhancing and non-enhancing lesions.
多发性硬化症（MS）是影响年轻人的最常见的致残性中枢神经系统疾病之一。磁共振成像（MRI）是诊断和随访多发性硬化症的重要工具。多年来，已开发出许多MRI技术以提高MS疾病检测的灵敏度。近年来，合成MRI（sMRI）和定量MRI（qMRI）在神经成像应用中受到关注，比传统采集方法提供更详细的信息。这些技术能够以高灵敏度检测大脑中的微观结构变化，并且对扫描仪间和观察者间的变异性具有鲁棒性。本研究旨在评估使用这些技术避免静脉注射钆基造影剂（GBCA）来评估MS疾病活动和监测的可行性。
42名年龄在20至４5岁之间的已知MS患者作为其常规随访的一部分接受扫描。合成MRI的一种实现方式——磁共振图像汇编（MAGiC）序列被添加到我们研究所的常规MS检查方案中，以自动生成T1、T2和质子密度（PD）的定量图谱。从代表正常外观白质（NAWM）、强化和非强化MS病变的感兴趣区域（ROI）收集T1、T2、PD和表观扩散系数（ADC）数据。对提取的信息进行比较、统计分析并计算灵敏度和特异性。
非强化MS病变的平均R1（T1的倒数）值为0.694 s-1（T1 = 1440 ms），强化病变为1.015 s-1（T1 = 985 ms），NAWM为1.514 s-1（T1 = 660 ms）。对于R2（T2的倒数）值，非强化病变的平均值为6.816 s-1（T2 = 146 ms），强化病变为8.944 s-1（T2 = 112 ms），NAWM为1.916 s-1（T2 = 522 ms）。PD值在非强化病变中平均为93.069%，强化病变中为82.260%，NAWM中为67.191%。对于ADC，非强化病变的平均值为1216.60×10-6 mm2/s，强化病变为1016.66×10-6 mm2/s，NAWM为770.51×10-6 mm2/s。
我们的结果表明，强化和非强化MS病变显著降低R1和R2值。与强化病变相比，非强化病变的R1和R2值显著更低。
相反，非强化病变中的PD值显著高于强化病变中的PD值。对于ADC，虽然NAWM的值较低，但强化和非强化病变的平均ADC值之间差异最小。
